My I.V.F. Education

“This is she,” I said, immediately entranced by the advent of good news.

“This is Jen, from the clinic? I just want to tell you that neither of your eggs fertilized.”

“What?” I said, taken aback by the dissonance between the lilt in her voice and what she was saying. “What do you mean?”

“Well, two eggs they retrieved yesterday? Neither fertilized,” she said, slowly. “They did not become embryos.”

“But … what … how?”

“You’ll have to talk to the doctor,” the nurse said, getting off the call.

I leaned against my silent cellphone, feeling completely blindsided. We’d finally gotten ready for another round of I.V.F. after the miscarriage — and now my eggs didn’t fertilize. How could this happen?

We live in an era in which health information is readily available on websites like WebMD and Drugs.com, and specialized I.V.F. sites such as Fertility Lab Insider, which is written by a former embryologist who explains every part of the process. But how much information is too much information? How much knowledge is really helpful, and how much is about feeling in control in a process in which there is so little?

When I started the I.V.F. process, I didn’t want to be like the women who come to the fertility clinics with folders full of research on the latest studies about medicines, protocols, supplements and tests. My good friend and her husband, a pediatrician who runs his wife’s blood tests through his lab to save money, were up on the latest research in every scientific journal, questioning their doctor at every step, switching clinics twice.

But Solomon and I aren’t like them. We’re less detail-oriented, more big-picture type of people. When we invite them to go on a hike, they’ll ask us: “Where are you going? How long will the hike be? How difficult is the hike? How much food should we bring?” Solomon and I would look at each other and shrug. We only know which direction we’re headed and to bring lots of water. We figure we’ll figure the rest out along the way.

But going on a hike isn’t the same as doing I.V.F. As I frantically redialed the clinic hoping to speak to a human, I was starting to realize that maybe I should be more like my friends.

There is so much out there written about I.V.F. – and since it’s a burgeoning field, none of it is definitive. That’s why I chose my doctor. I believe in his methodology. And I was loathe to second-guess his every move. Besides, I know how doctors fear the “Internet educated” patients, suggesting their own courses of treatment.

But maybe he wasn’t infallible. With so many others involved in an I.V.F. cycle – a shifting rotation of doctors (who don’t all agree on protocol), embryologists and sometimes overscheduled nurses – a lot of things can go wrong.

I found this out as I waited for the doctor’s call. Googling “I.V.F. eggs didn’t fertilize,” I learned that eggs often don’t make it to embryos for a number of reasons: They may not be mature enough, they may be chromosomally abnormal, the sperm might not have penetrated the outer layer of the egg, or the sperm and egg may not be compatible.

On the fertility boards, women blamed their clinics for the using the wrong medications, for timing the retrievals too early – or too late. Everyone was talking about the use of ICSI. In Intracytoplasmic Sperm Injection, they inject a single sperm directly into an egg in order to fertilize it, instead of placing all the sperm and the eggs in the petri dish.

When we first started I.V.F., I remembered that we signed a form giving the clinic permission to do ICSI, but I had no idea if they’d done it with our eggs and sperm.

I felt like such an idiot. How could I not know something so important? It seemed essential to be on top of this, especially since there was the option of “rescue ICSI,” in which, if traditional fertilization fails, they can immediately inject the sperm into the egg.

I was beating myself up for my naïveté. By the time the embryologist called the next day, explaining how they didn’t do ICSI because it hadn’t been necessary the previous cycle, it was even too late to do a rescue.

“I’ll put it ICSI in the file for next time,” she said.

Ah. Next Time. This time my eggs were gone. With them, the money for half a cycle.

Next time, I’ll make certain they do ICSI. I’ll also be more educated about my fertility, understand the medicines I’m taking, what my blood tests mean and when my retrieval is timed. It may not make for a pleasant patient, but maybe it will help us have a baby.

About

We're all living the family dynamic, as parents, as children, as siblings, uncles and aunts. At Motherlode, lead writer and editor KJ Dell’Antonia invites contributors and commenters to explore how our families affect our lives, and how the news affects our families—and all families. Join us to talk about education, child care, mealtime, sports, technology, the work-family balance and much more